Preoperative use of tissue plasminogen activator for large submacular hemorrhage. Ophthalmic Surg Lasers 1999 Mar;30(3):176-80
Date
04/01/1999Pubmed ID
10100249Scopus ID
2-s2.0-0033044147 (requires institutional sign-in at Scopus site) 25 CitationsAbstract
BACKGROUND AND OBJECTIVE: Tissue Plasminogen Activator (TPA) has been used as an adjunct in the surgical removal of submacular hemorrhage. It is usually used intraoperatively, but may not provide enough time for effective fibrinolysis, especially for a large hemorrhage. The present study was conducted to evaluate the efficiency and safety of preoperative use of TPA for large submacular hemorrhages.
METHODS: Five eyes with large submacular hemorrhage secondary to age-related macular degeneration underwent subretinal injection of TPA in the office 24 hours before surgery. All hemorrhages were less than seven days old and at least 3 mm thick.
RESULTS: Preoperative visual acuity ranged from counting fingers to hand motion (HM). Patient follow-up ranged from 3 months to 24 months (mean, 11 months). Final visual acuity ranged from 20/30 to HM. Four of the five eyes (80%) showed improved visual acuity after surgery and 3/5 (60%) attained visual acuity of 20/200 or better.
CONCLUSION: Preoperative use of TPA for drainage of large submacular hemorrhage appears to be safe and may result in efficient clot removal. The true efficacy of TPA in the treatment of submacular hemorrhage can only be proven by a prospective randomized trial.
Author List
Chaudhry NA, Mieler WF, Han DP, Alfaro VD 3rd, Liggett PEMESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Fibrinolysis
Fibrinolytic Agents
Fluorescein Angiography
Follow-Up Studies
Fundus Oculi
Humans
Injections
Macular Degeneration
Preoperative Care
Retinal Hemorrhage
Safety
Suction
Tissue Plasminogen Activator
Treatment Outcome
Visual Acuity
Vitrectomy
